Traumatic aneurysm of the internal carotid artery (ICA) occasionally may present with delayed cataclysmic epistaxis. Lack of awareness of this phenomenon has led to misdiagnosis and delay of treatment in many instances. Consequently, this clinical scenario is associated with a high rate of mortality. Analysis of this entity allows division of management into an immediate phase where bleeding is stopped, the patient is stabilized, and a later phase where definitive treatment is rendered. To gain a fuller understanding of this potentially life-threatening problem, the following case is presented.
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